<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <!-- saved from url=(0041)file://\\Nazi\e\sol-end\eng-maghale-2.htm --> <HTML><HEAD> <meta http-equiv="Content-Language" content="en-us"> <TITLE>Professor Soltanzadeh</TITLE> <META http-equiv=Content-Type content="text/html; charset=unicode"> <META content="Microsoft FrontPage 5.0" name=GENERATOR> <META content=FrontPage.Editor.Document name=ProgId> <style> <!-- h1 {margin-bottom:.0001pt; text-align:left; page-break-after:avoid; direction:rtl; unicode-bidi:embed; font-size:14.0pt; font-family:"Times New Roman"; margin-left:0cm; margin-right:0cm; margin-top:0cm} h2 {margin-bottom:.0001pt; page-break-after:avoid; font-size:16.0pt; font-family:"Times New Roman"; font-weight:normal; margin-left:0cm; margin-right:0cm; margin-top:0cm} h3 {margin-top:0cm; margin-right:21.75pt; margin-bottom:0cm; margin-left:0cm; margin-bottom:.0001pt; text-indent:-21.75pt; page-break-after:avoid; tab-stops:list 21.75pt; font-size:14.0pt; font-family:"Times New Roman"; } --> </style> </HEAD> <BODY text=#000000 vLink=#ff0000 aLink=#0000ff link=#0000ff bgProperties=fixed bgColor=#ffffff leftMargin=0 background="foriegnarticle2_files/bg4 copy.gif" topMargin=0> <DIV align=left> <TABLE height=61 cellSpacing=0 cellPadding=0 width=706 border=0> <TBODY> <TR> <TD vAlign=bottom align=justify width=166 height=1><IMG height=140 src="foriegnarticle2_files/toppage3.gif" width=166 border=0></TD> <TD width=673 background=foriegnarticle2_files/bgew.gif height=1> <DIV align=left> <TABLE height=136 cellSpacing=0 cellPadding=0 border=0 width="613"> <TBODY> <TR> <TD colSpan=4 height=46 width="290"> <P align=center><IMG height=36 src="foriegnarticle2_files/Toptext7.gif" width=255 border=0></P></TD> <TD height=46 width="50"></TD> <TD height=46 width="45"></TD> <TD height=46 width="120"></TD> <TD colSpan=2 height=46 width="118"><IMG height=40 src="foriegnarticle2_files/inkscroll.gif" width=65 align=right border=0></TD></TR> <TR> <TD height=36 width="40"><a href="tamas.htm"><IMG height=30 src="foriegnarticle2_files/But8copy.gif" width=40 border=0></a></TD> <TD height=36 width="80"><a href="karhay.htm"><IMG height=30 src="foriegnarticle2_files/But7copy.gif" width=80 border=0></a></TD> <TD height=36 width="115"><a href="tarh.htm"><IMG height=30 src="foriegnarticle2_files/b1.gif" width=115 border=0></a></TD> <TD height=36 width="55"><a href="maghale.htm"><IMG height=30 src="foriegnarticle2_files/b2.gif" width=55 border=0></a></TD> <TD height=36 width="50"><a href="kongereh.htm"><IMG height=30 src="foriegnarticle2_files/But4copy.gif" width=50 border=0></a></TD> <TD height=36 width="45"><a href="talifat.htm"><IMG height=30 src="foriegnarticle2_files/But3copy.gif" width=45 border=0></a></TD> <TD height=36 width="120"><a href="moarefi.htm"><IMG height=30 src="foriegnarticle2_files/But1copy.gif" width=120 border=0></a></TD> <TD vAlign=bottom height=36 width="84"><a href="index.htm"><IMG height=30 src="foriegnarticle2_files/But10copy.gif" width=80 border=0></a>&nbsp;</TD> <TD height=36 width="34">&nbsp;&nbsp;&nbsp;&nbsp;</TD></TR> <TR> <TD align=left colSpan=9 height=54 width="623"> <p class="MsoNormal" style="text-autospace: none"> &nbsp;</TD></TR></TBODY></TABLE></DIV></TD></TR> <TR> <TD vAlign=top align=justify width=166 height=180><IMG height=174 src="foriegnarticle2_files/toppage1.gif" width=114 align=top border=0></TD> <TD width=673 height=180> <DIV align=left> <TABLE cellSpacing=0 cellPadding=4 width=587> <TBODY> <TR> <TD width="579"> <p align="left"> <b><span style="font-size: 16.0pt; font-family: Times New Roman"> BREAST-FEEDING AND WEANING</span></b></p> <p align="left">&nbsp;</p> <TR> <TD width="579"> <table border="0" cellpadding="2" style="border-collapse: collapse" bordercolor="#111111" width="100%" id="AutoNumber1" bgcolor="#4D7565"> <tr> <td width="100%" bordercolor="#4D7565"><b><font color="#FFFFFF"><span dir="LTR">1&nbsp;&nbsp;&nbsp; BREAST-FEEDING</span></font></b></td> </tr> </table> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: -18.0pt; direction: ltr; unicode-bidi: embed; margin-left: 18.0pt"> <span style="font-family: Symbol"> <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span> <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp; </span></span><span dir="LTR">The easy availability of mother s milk, its sterility, its temperature and its composition are ideal for optimal growth. Breast-feeding supports the emotional development of the child , through enjoyment of an essential and privileged relationship with his/her mother. Mother s milk is the best food that can be offered to the infant from 0 to 4 months of age ; breast-feeding can be continued for 1 to 2 years providing that the child receives other necessaary foods;</span></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: -18.0pt; direction: ltr; unicode-bidi: embed; margin-left: 18.0pt"> <span style="font-family: Symbol"> <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span> <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp; </span></span><span dir="LTR">The composition of breast milk develops according to the infant s needs for growth ; the nutritional and immunological properties of breast milk are adapted to the child s needs;</span></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: -18.0pt; direction: ltr; unicode-bidi: embed; margin-left: 18.0pt"> <span style="font-family: Symbol"> <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span> <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp; </span></span><span dir="LTR">The quantity of breast milk is theoretically sufficient for the needs of the child unit the age of 4 to 6 months ; this depends on the effective stimulation of the nipple by sucking and on emptying the breast. Errors in the technique of breast-feeding, as well as malnutrition or a depressive state in the mother; can suppress breast milk production.</span></p> <h2 dir="LTR"><u><b><font size="3" color="#800080">PRACTICAL WAYS TO DEAL WITH BREAST-FEEDING</font></b></u></h2> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <b>1.</b><span style="font-style:normal; font-variant:normal; font-size:7.0pt; font-family:Times New Roman; font-weight:700"> </span><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;</span><span dir="LTR"><b>Slow onset of lactation,</b></span> sometimes taking 4 to 5 days.</p> <p class="MsoNormal" dir="LTR" style="text-align:justify;text-justify:kashida; text-kashida:0%;direction:ltr;unicode-bidi:embed">Sucking stimulus of the nipple encourages the flow of the milk . The infant should be put to the breast as early as <b>the first hours of life</b>; indeed any colostrum it takes is nourishing and the smallest amount of sucking will help stimulate milk production.</p> <p class="MsoNormal" dir="LTR" style="text-align:justify;text-justify:kashida; text-kashida:0%;direction:ltr;unicode-bidi:embed">To increase the production of milk , it is also necessary to:</p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp; </span></span><span dir="LTR">feed the mother adequately;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp; </span></span><span dir="LTR">encourage her to drink;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp; </span></span><span dir="LTR">allow her to rest;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp; </span></span><span dir="LTR">calm her and reassure her.</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <b>2.</b><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span><span dir="LTR"><b>Cracks in the nipple:</b></span> small, superficial but painful coetaneous lesions, caused by chronic irritation or poor hygiene.</p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp; </span></span><span dir="LTR"><b>Prevention:</b></span> clean hands, washing the nipple with cooled boiled water , keeping the nipple dry and covered.</font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;"> </span></span><span dir="LTR"><b>Treatment: </b></span>cleaning and drying the nipples , and the application of a <b>2% aqueous solution of eosin</b> (not harmful for the infant).</font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;</span></span></font><span dir="LTR"><font color="#000080">Because stopping sucking suppresses lactation and causes painful engorgement of the breats and may cause mastitis or breast abscess, it is essential to continue feeding. This should be done by either continuing to offer the breast, or by expressing the breast gently and regularly to empty it . The milk can be given to the infant with a spoon</font>.</span></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <b>3.</b><span style="font:7.0pt &quot;Times New Roman&quot;"> </span><span dir="LTR"><b>Mastitis:</b></span> infection of the mammary gland.</p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:justify; text-justify:kashida;text-kashida:0%;direction:ltr;unicode-bidi:embed">Early sings: swelling, heat and reddening , local or diffuse ; pain, sometimes considerable.</p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:left; direction:ltr;unicode-bidi:embed"><b>Treatment:</b></p> <p class="MsoNormal" dir="LTR" style="text-align: left; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">Wrapping in cold or chilled compresses;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: left; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span dir="LTR">anti-inflammatory drugs (aspirin, 3 g/day in three doses for 48 hours);</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: left; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;"> </span></span><span dir="LTR">(e.g.spiramycin, 3 g/day in three doses for 7 days);</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: left; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">expressing the affected breast gently and <b>discarding</b> the milk;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: left; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;"> </span></span><span dir="LTR">continuing to offer the other breast to the infant.</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <b>4.</b><span style="font-style:normal; font-variant:normal; font-weight:700; font-size:7.0pt; font-family:Times New Roman"> </span><span dir="LTR"><b>Abscess: </b></span>a collection of pus in the mammary gland.</p> <p class="MsoNormal" dir="LTR" style="text-align:justify;text-justify:kashida; text-kashida:0%;direction:ltr;unicode-bidi:embed">Clinical signs of abscess formation: localised,very painful, hot and red.</p> <p class="MsoNormal" dir="LTR" style="text-align:justify;text-justify:kashida; text-kashida:0%;direction:ltr;unicode-bidi:embed"><b>&nbsp;Treatment:</b> in addition to the treatment for mastitis:</p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">incision and drainage when the abscess is fluctuant;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">the infant can return to the breast as soon as the abscess is cured.</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <b>5.<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></b><span dir="LTR"><b> My milk is not good </b></span> , or <b> I don t have enough milk </b>, or<b>  My child does not want the breast any more </b></p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:justify; text-justify:kashida;text-kashida:0%;direction:ltr;unicode-bidi:embed"> Contraindications for breast-feeding are very uncommon and usually temporary. Basides , a healthy child is hungry. If the mother says that the child does not want the breast but  accepts the bottle , a reason must be sought.</p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:justify; text-justify:kashida;text-kashida:0%;direction:ltr;unicode-bidi:embed"><b> Management:</b></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp; </span></span><span dir="LTR">explain the benefits of breast  feeding to the mother and find out,without making her feel guilty the reason for her choice,</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp; </span></span><span dir="LTR">if it appears that breast-feeding is not possible find out:</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: -18.0pt; direction: ltr; unicode-bidi: embed; margin-left: 32.4pt; margin-right: 18.0pt; margin-top: 0cm; margin-bottom: .0001pt"> <font color="#800000">&nbsp;&nbsp; -<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span dir="LTR">if she has the material and financial means necessary for artificial feeding (allow for&nbsp;&nbsp;&nbsp;&nbsp; 2 to 3 kg of mild powder per month);</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: -18.0pt; direction: ltr; unicode-bidi: embed; margin-left: 32.4pt; margin-right: 18.0pt; margin-top: 0cm; margin-bottom: .0001pt"> <font color="#800000">&nbsp;&nbsp; -<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span dir="LTR">whether she is capable of correctly preparing an infant formula;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp; </span></span><span dir="LTR">if the child is ready for <b> supplementation</b> (3 to 4 months ) or for <b>introduction of solids</b>, recommend an adequate complementary food.</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: -21.75pt; direction: ltr; unicode-bidi: embed; margin-right: 21.75pt"> 1<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span> <b>6.<span style="font:7.0pt &quot;Times New Roman&quot;"> </span></b><span dir="LTR"><b> My child is always at the breast </b> or <b> My child falls asleep whilst&nbsp; at the breast </b></span></p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:justify; text-justify:kashida;text-kashida:0%;direction:ltr;unicode-bidi:embed">Simple conditions must be met so that breast-feeding goes well:</p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol"><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">the mother must be relaxed and comfortable, either sitting or lying down , and wanting to feed her baby;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol"><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp; </span></span><span dir="LTR">the infant must be relaxed , not tired , not satiated , nostrils clear, not pressed against the breast;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol"><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp; </span></span><span dir="LTR">the nipples must be cleaned before and after each feed;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol"><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp; </span></span><span dir="LTR">the infant s sucking reflex is stimulated by introducing the nipple into its mouth and by preliminary gentle stroking of the lips;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol"><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">the breast should be gently squeezed to produce a few drops of milk for the infant to taste, a maneuver which will stimulate and maintain sucking and the letdown reflex;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol"><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">the continuing secretion of milk should be maintained by gentle squeezing of the breast; the infant should be stimulated (e.g. by caressing, talking, singing and looking);</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol"><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">in this way, the infant will have an adequate meal , followed by a period of digestion , after which he will wake up for the next meal. The <b>frequency of feeding</b> is determined by the infant according to appetite, but for a term infant there should be at least six feeds per day in the first months; and there should be even more frequent feeds for premature infants . The infant who sleeps too much should be awakened for feeding; <b>the more often he suckles</b>, <b>the more milk the mother will have</b> . sugar water from a bottle must not be given.</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <b>7.</b><span style="font:7.0pt &quot;Times New Roman&quot;"> </span><span dir="LTR"><b> I must go to work </b></span> or <b> I have to go to the market </b></p> <p class="MsoBodyTextIndent2" dir="LTR" style="text-align:justify;text-justify: kashida;text-kashida:0%">A mother s&nbsp; social life and the economic needs of the family sometimes cause a lactating mother to leave the house to work or go to the market.</p> <p class="MsoBodyTextIndent2" dir="LTR" style="text-align:justify;text-justify: kashida;text-kashida:0%">Sometimes she cannot or  will not take her child with her. Although she must be encouraged (many mothers feed on demand and offer the breast whiled following their occupation), and although the lactating&nbsp; mother must be spared the heavier takes, the health supervisor may sometimes have to agree to an occasional artificial feed , provided it is properly made up , according to the strict rules of hygiene.</p> <p class="MsoBodyTextIndent2" dir="LTR" style="text-align:justify;text-justify: kashida;text-kashida:0%">&nbsp;</p> <table border="0" cellpadding="2" style="border-collapse: collapse" bordercolor="#111111" width="100%" id="AutoNumber3" bgcolor="#4E7864"> <tr> <td width="100%"><font color="#FFFFFF"><b>&nbsp;2</b><span style="font-style:normal; font-variant:normal; font-weight:700; font-size:7.0pt; font-family:Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><b><span dir="LTR">ARTIFICIAL FEEDING</span></b></font></td> </tr> </table> <p class="MsoBodyText" dir="LTR" style="text-indent: -21.0pt; margin-left: 0cm; margin-right: 21.0pt; margin-top: 0cm; margin-bottom: .0001pt"> &nbsp;</p> <p class="MsoBodyText" dir="LTR" style="text-indent: -21.0pt; margin-left: 0cm; margin-right: 21.0pt; margin-top: 0cm; margin-bottom: .0001pt"> 1.<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span style="font-style:normal; font-variant:normal; font-weight:700; font-family:Times New Roman">&nbsp;&nbsp;1. </span><font color="#FF0000"><span dir="LTR"><b>Choice of milk:</b></span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: left; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">do not use milk which is not adapted for infants;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: left; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;</span></span><span dir="LTR">most infant milk formulas are suitable for all infants; they consist of cow s milk which has been <b> modified</b> and <b>enriched</b> to satisfy the normal nutritional requirements of infants and adapted to their physiological characteristics.</span></font></p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:left; direction:ltr;unicode-bidi:embed">Infant formula may also be prepared at home in which case it is described as  home-prepared (WHO International Code of Marketing of Breast-milk Substitutes, Geneva1981).</p> <p class="MsoNormal" dir="LTR" style="text-align: left; text-indent: -21.0pt; direction: ltr; unicode-bidi: embed; margin-right: 21.0pt"> 2.<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span style="font-style:normal; font-variant:normal; font-family:Times New Roman; font-weight:700"> 2.</span><span style="font-style:normal; font-variant:normal; font-size:7.0pt; font-family:Times New Roman; font-weight:700">&nbsp;<font color="#FF0000">&nbsp; </font> </span><font color="#FF0000"><b><span dir="LTR">Choice of water:</span></b></font></p> <p class="MsoNormal" dir="LTR" style="text-align: left; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">Clean drinking water will do , if possible boiled and filtered;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: left; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">Of the bottled waters, only those with <b>low mineral content</b> are suitable.</span></font></p> <p class="MsoBodyText" dir="LTR" style="text-indent: -21.0pt; margin-left: 0cm; margin-right: 21.0pt; margin-top: 0cm; margin-bottom: .0001pt"> 3.<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span> <span style="font-style:normal; font-variant:normal; font-family:Times New Roman; font-weight:700"> 3.</span><span style="font:7.0pt &quot;Times New Roman&quot;"> </span> <span style="font-style:normal; font-variant:normal; font-size:7.0pt; font-family:Times New Roman; font-weight:700">&nbsp; </span><font color="#FF0000"><span dir="LTR"><b>Choice of feeding utensils:</b></span></font></p> <p class="MsoBodyText" dir="LTR" style="text-indent: -21.0pt; margin-left: 0cm; margin-right: 21.0pt; margin-top: 0cm; margin-bottom: .0001pt"> &nbsp;</p> <p class="MsoBodyText" dir="LTR" style="text-indent: 0cm; margin-left: 0cm; margin-right: 18.0pt; margin-top: 0cm; margin-bottom: .0001pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">as far as possible , use a <b>cup</b> and <b>spoon</b> for easier cleaning;</span></font></p> <p class="MsoBodyText" dir="LTR" style="text-indent: 0cm; margin-left: 0cm; margin-right: 18.0pt; margin-top: 0cm; margin-bottom: .0001pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">glass feeding bottles (which can be more reliably washed and sterilized) with simple and clear graduation marks, preferably at 30 ml intervals;</span></font></p> <p class="MsoBodyText" dir="LTR" style="text-indent: 0cm; margin-left: 0cm; margin-right: 18.0pt; margin-top: 0cm; margin-bottom: .0001pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">bottles and teats should be carefully washed and boiled for 15 minutes each time before use; they should be sterilized in a pan or in a special sterilizer.</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: -21.0pt; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 4.<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;</span></b><font color="#FF0000"><span dir="LTR"><b> Making up the milk:</b></span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">it must be <b>very carefully</b> prepared; the hands must be washed beforehand;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">most tins of infant formula contain a measure marked with its capacity (usually 4.5g).The measure should be filled level , not heaped , say 4.5g in 30g water, 2 measures for 60g water, 3 for 90 g and so on;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">put a little tepid water in the bottle , add the measures of infant formula; shake to dissolve; than add water up to the required amount;</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;"> </span></span><span dir="LTR">carefully close the tin after use.</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;"> </span></span><span dir="LTR">Remarks about the use of <b>ordinary milk powder</b> : after making up according to the instructions on the tin, it is necessary for infants up to 6 months of age to dilute it by putting one part of water in the bottle and adding two parts of reconstituted milk up to the quantity required; 5% sugar must also be added</span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: -21.0pt; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>&nbsp;5.</b><span style="font-style:normal; font-variant:normal; font-family:Times New Roman; font-weight:700"> </span><b><font color="#FF0000"><span dir="LTR">Quantities of milk to be given:</span></font></b></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp; </span></span><span dir="LTR"><b>Apert s rule:</b></span></font></p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:justify; text-justify:kashida;text-kashida:0%;direction:ltr;unicode-bidi:embed"> <font color="#000080">Total quantity (ml) per 24h=weight in grams/10+200</font></p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:justify; text-justify:kashida;text-kashida:0%;direction:ltr;unicode-bidi:embed"> <font color="#000080">This must then be divided by the number of feeds in the day (6 or 5 according to the age).</font></p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:justify; text-justify:kashida;text-kashida:0%;direction:ltr;unicode-bidi:embed"> <font color="#000080">As soon as solid foods are introduced , this must be considered when calculating the total required.</font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">Always prepare a little more than the child will take ; this avoids involuntarily restricting the amount taken; it is the child and its growth which ought to dictate the size of the feeds.</span></font></p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:justify; text-justify:kashida;text-kashida:0%;direction:ltr;unicode-bidi:embed"><b>N.B.</b> : do not keep the rest of the milk for the baby; give it to the older children</p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: -21.0pt; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <b>6.<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span><span style="font-style:normal; font-variant:normal; font-family:Times New Roman">6.&nbsp;</span><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;<font color="#FF0000"> </font> </span></b><font color="#FF0000"><span dir="LTR"><b>Number of bottles:</b></span></font></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: 0cm; direction: ltr; unicode-bidi: embed; margin-right: 18.0pt"> <font color="#000080"> <span style="font-family: Symbol">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span></span><span dir="LTR">At the beginning, the baby demands frequent feeds but by 6 to 7 months feeds 4 times a day, as adults do.</span></font></p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:justify; text-justify:kashida;text-kashida:0%;direction:ltr;unicode-bidi:embed">As with the size of the feeds , it is the infant and its rate of growth which determine their frequency.</p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:justify; text-justify:kashida;text-kashida:0%;direction:ltr;unicode-bidi:embed">Most children are happy with 6 to 8 feeds a day from the first days of life until they are 3 or 4 months old; they usually take 5 feeds a day between 4 and 6 months , and after that change to 4 feeds day.</p> <p class="MsoNormal" dir="LTR" style="margin-left:14.4pt;text-align:left; direction:ltr;unicode-bidi:embed">&nbsp;</p> <table border="0" cellpadding="2" style="border-collapse: collapse" bordercolor="#111111" width="100%" id="AutoNumber4" bgcolor="#4E7864"> <tr> <td width="100%"><font color="#FFFFFF"><b>&nbsp;3</b><span style="font-style:normal; font-variant:normal; font-weight:700; font-family:Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp; </span><b><span dir="LTR">VARYING THE DIET</span></b></font></td> </tr> </table> <p class="MsoNormal" dir="LTR" style="text-align:left;direction:ltr;unicode-bidi: embed">Exclusive milk feeding in early life is adequate for growth but after 4-6 months of age , mother s milk is not enough for&nbsp; the infant s requirements . It is therefore, absolutely necessary from 6 months or earlier that the infant has at least one non-milk feed each day.</p> <p class="MsoNormal" dir="LTR" style="text-align:left;direction:ltr;unicode-bidi: embed"><img border="0" src="abnormal/tropical1.jpg" width="500" height="269"></p> <p class="MsoNormal" dir="LTR" style="text-align:left;direction:ltr;unicode-bidi: embed"><b><font size="2" color="#008080">Fig.1-How to feed a young child properly .</font></b></p> <p class="MsoNormal" dir="LTR" style="text-align:left;direction:ltr;unicode-bidi: embed">The first more solid feed (gruel) should be offered at about 4 months: this is known as <b>supplementation</b> and is usually well tolerated. At about 5 or 6 months, a more <b>varied diet</b> (e.g. vegetables ,meat ,fish, egg, cheese ,yoghurt) should be given; this may be accepted reluctantly, even refused.</p> <p class="MsoNormal" dir="LTR" style="text-align:left;direction:ltr;unicode-bidi: embed">Refusal may be a normal expression of the infant s personality. When this happens, it is important to reassure the mother and to encourage her to persist.</p> <p class="MsoNormal" dir="LTR" style="text-align:left;direction:ltr;unicode-bidi: embed">&nbsp;</p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-indent: -21.75pt; direction: ltr; unicode-bidi: embed; margin-right: 21.75pt"> <b>4<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;</span></b></p> <table border="0" cellpadding="2" style="border-collapse: collapse" bordercolor="#111111" width="100%" id="AutoNumber5" bgcolor="#4E7864"> <tr> <td width="100%"><font color="#FFFFFF"> <b><span style="font-style:normal; font-variant:normal; font-family:Times New Roman">&nbsp;4</span><span style="font:7.0pt &quot;Times New Roman&quot;"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></b><span dir="LTR"><b>HOW TO FEED A CHILD PROPERLY (FIG.1)</b></span></font></td> </tr> </table> <p class="MsoNormal" dir="LTR" style="text-align:justify;direction:ltr;unicode-bidi: embed"></p> <p class="MsoBodyText" dir="LTR" style="text-align: justify; text-indent: -21.75pt; margin-left: 0cm; margin-right: 21.75pt; margin-top: 0cm; margin-bottom: .0001pt"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>1.</b><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span><span dir="LTR">Offer the breast <b>from</b> birth.</span></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-indent: -21.75pt; direction: ltr; unicode-bidi: embed; margin-right: 21.75pt"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>&nbsp;2.</b><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span><span dir="LTR">Breast-feed for 24 months if possible , and in <b>any case</b> until a complete and varied diet is accepted by the child.</span></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-indent: -21.75pt; direction: ltr; unicode-bidi: embed; margin-right: 21.75pt"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>3.</b><span style="font-style:normal; font-variant:normal; font-size:7.0pt; font-family:Times New Roman; font-weight:700"> </span><span dir="LTR">Bottle-feeding is potentially dangerous for all infants; whenever&nbsp; bottle feeding is necessary, make feeds up very carefully , strictly obeying the rules of hygiene and composition.</span></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-indent: -21.75pt; direction: ltr; unicode-bidi: embed; margin-right: 21.75pt"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>4.</b><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span><span dir="LTR">Supplementary foods are not needed until 4 months of age . From then , or earlier if the weight curve falters, a <b>supplement</b> (e.g. gruel) should be given with a spoon.</span></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-indent: -21.75pt; direction: ltr; unicode-bidi: embed; margin-right: 21.75pt"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>5.</b><span style="font:7.0pt &quot;Times New Roman&quot;"> </span><span dir="LTR"><b>Gruels</b></span> should be cereal-based and enriched with one or , preferably , several locally available foodstuffs , rich in proteins and fats.</p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-indent: -21.75pt; direction: ltr; unicode-bidi: embed; margin-right: 21.75pt"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>&nbsp;6.</b><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp; </span><span dir="LTR">From the age of <b>6 months</b>, the infant should have the following once or twice a day:</span><span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></p> <table border="0" cellpadding="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" width="100%" id="AutoNumber6"> <tr> <td width="100%"> <center> <span style="font-style:normal; font-variant:normal; font-weight:700; font-family:Times New Roman"><font size="2"> </font>&nbsp;&nbsp; <img border="0" src="abnormal/milk.jpg" align="left" width="442" height="169"></span></td> </tr> </table> <p class="MsoBodyTextIndent" dir="LTR" style="text-align:justify;text-justify:kashida; text-kashida:0%">&nbsp;&nbsp; <font color="#910091"><b>Infants should have at least 4 meals a day until the age of 5 years.</b></font></p> <p class="MsoBodyTextIndent" dir="LTR" style="text-align: justify; text-indent: -21.75pt; margin-right: 21.75pt"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>7.</b><span style="font:7.0pt &quot;Times New Roman&quot;"> </span><span dir="LTR">From 6 months, infants should take part in <b> family meals</b> , which should contain a&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; variety of foods; spices should not be given.</span></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-indent: -21.75pt; direction: ltr; unicode-bidi: embed; margin-right: 21.75pt"> 8.<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span dir="LTR">Refusal to eat is very common in young children .&nbsp; Check that the diet is well-balanced;&nbsp;&nbsp;&nbsp;&nbsp; have the child weighed and carefully examined.</span></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-indent: -21.75pt; direction: ltr; unicode-bidi: embed; margin-right: 21.75pt"> 9.<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span dir="LTR">Sick children need semi-liquid diets which must be very nourishing and enriched with&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; fresh fats and sugar.</span></p> <p class="MsoNormal" dir="LTR" style="text-align: justify; text-indent: -21.75pt; direction: ltr; unicode-bidi: embed; margin-right: 21.75pt"> 10.<span style="font:7.0pt &quot;Times New Roman&quot;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span dir="LTR">Children with </span>diarrhoea<span dir="LTR"> should be kept on the breast and given oral dehydration solution .</span></p> <p class="MsoBodyText" dir="LTR" style="text-align:justify;text-justify:kashida; text-kashida:0%">Meals should be nourishing , for example a mixture of curdled milk , oil and sugar, which does not aggravate the diarrhoea . If vomiting occurs , patiently persist with small quantities at a time by spoon , without giving more than a small bowlful (150-200 g).</p> <hr> </TR></TBODY></TABLE></DIV> <font color="#FF0000"><b>TROPICAL PAEDIATRICS </b></font>&nbsp;<font color="#800000" size="2"><b>(HANDBOOK)</b></font><table border="0" cellpadding="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" width="95%" id="AutoNumber2"> <tr> <td width="100%"> <hr> </td> </tr> </table> <DIV align=left> <TABLE height=67 cellSpacing=0 cellPadding=0 width=599 border=0> <TBODY> <TR> <TD width=579 height=65> <P class=MsoNormal dir=rtl style="MARGIN-BOTTOM: -15px; DIRECTION: rtl; unicode-bidi: embed; mso-pagination: none; mso-layout-grid-align: none" align=center><a href="index.htm">Home page</a>&nbsp; |&nbsp;<a href="eng-moarefi.htm">Introduction</a>&nbsp;|&nbsp;<a href="eng-tarh.htm"> Research Studies</a>&nbsp; |&nbsp;<a href="eng-talifat.htm"> Editorships</a>&nbsp; |&nbsp;<a href="eng-translate.htm"> Translations</a>&nbsp; |&nbsp;<a href="eng-kongereh.htm"> Conferences</a>&nbsp; </P> <P class=MsoNormal dir=rtl style="MARGIN-BOTTOM: -15px; DIRECTION: rtl; unicode-bidi: embed; mso-pagination: none; mso-layout-grid-align: none" align=center><a href="eng-tamas.htm">Contact Information</a>&nbsp; |&nbsp;<a href="eng-maghale.htm"> Articles</a>&nbsp; |&nbsp;<a href="news.htm"> Scientific meets &amp; events</a>&nbsp; |&nbsp;<a href="research.htm"> Research projects</a>&nbsp; |&nbsp; Theses</P></TD></TR></TBODY></TABLE></DIV></TD></TR></TBODY></TABLE></DIV></BODY></HTML>